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Anxiety Unknown Oral or possible Unprotected vaginal exposures

Subject  visited Prague 115 days ago and there was a possibility of insertive oral sex or an unknown vaginal insertion but does not actually know if it was commenced. This person does remember being approached by Czech and even scarier African prostitutes. There have been no real known symptoms from this incident thus far.
If 70 days ago a different csw performed unprotected oral sex on him, and was to  also perform unprotected cunnilingus  and analingus  what would be possible hiv exposure risks be? After this incident the person experienced oral ulcers and mild sore throat 2 weeks 14 days afterward and approximately 85 days after Prague. He had been taking echinacea and lysine as a preventative measure against HSV infections. Echinacea has possible known side effects after causing oral ulcers but so does hiv.

Here are the questions.
What if any risks are of oral insertive  or receptive  exposures for HIV when he also bites inside of own mouth?

Are  oral ulcers and sporadic itching of legs and arms  concern 2 weeks after oral exposure or 12 weeks after possible vaginal or can Echinacea possibly be the problem since no ulcers have shown since after discontinued use ? Allergies seasonal to pollen. The canker sores also caused inflammation of submandibular lymph node on the side they were located.

This is all very nerve wracking and an oraquick test has been ordered since now There has been vaginal insertion now passed on to sex partner and thus breast feeding bab,, which raises concerns of harming them. What are now their residual risks of an oral and at worst 1 time vaginal unprotected sex?

Is the known receptive cunnilingus and insertive fellatio with csw unprotected . There is only a 50/50 chance that unprotected vaginal sex ever occurred 1 time with Prague csw and that is major reason for test.

No Fevers , no Diarrhea even a surgery to extract ganglion cyst has occurred that was sent to pathologist  ; is HIV tested at that time?
6 Responses
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239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the forum.  Thanks for your question.  

Many websites, public health agencies, etc have a take-no-chances policy, i.e. a CYA stance based on advice from their legal departments.  They often recommend against all sexual practices that have (or were once thought to have) even a theoretical risk of transmisison, even if there are few or no cases of actual HIV transmission.  On this forum, however, we rely on data about actual documented transmissions.

Oral sex on men -- i.e. fellatio, perhaps especially when there is ejaculation in the mouth -- probably has resulted in a few HIV infections in the oral partners.  However, HIV has never been believably transmitted to the insertive (penile) partner in fellatio, by cunnilingus (to either partner), or by kissing.  Sores in the mouth (tooth wounds, canker sores, gum inflammation, etc) are extremely common, and yet still almost nobody catches HIV by oral exposure.  Therefore, it is apparent that they make no significant difference in risk.

Here are links to several threads that go into these issues in greater detail. Read the follow-up comments in addition to the initial answers.

http://www.medhelp.org/posts/show/1415872
http://www.medhelp.org/posts/show/1526411
http://www.medhelp.org/posts/show/1721189
http://www.medhelp.org/posts/show/1830230
http://www.medhelp.org/posts/show/1884090

For those reasons, the "subject" of your question (I'm assuming it's you) is not at risk of HIV from the events you have described.  I don't buy the possibility there was vaginal penetration that you "don't know" about.  But even if there were, the transmission risk from any single vaginal sex exposure is low (average 1 chance in 2,000 if the female has HIV).

Therefore, you can expect your upcoming test to be negative.  An HIV antibody test, including Oraquick, is conclusive at 115 days after the last exposure.  When it is, you can move on with 100% certainty you didn't catch HIV.  Your symptoms make no difference.  Even if the symptoms or their timing were typical for ARS (they are not), testing always overrules both symptoms and exposure history.

Feel free to return with a comment to report the test result.  However, it is pointless to speculate when a definitive answer will soon be available -- so let's not have any further discussion until then.

Regards--  HHH, MD
Helpful - 1
239123 tn?1267647614
MEDICAL PROFESSIONAL
Six month testing is never required, despite what you can find on various online sources.  See this thread:  http://www.medhelp.org/posts/show/1704700

That should wind up this thread.  I don't have any further comments.  Do your best to move on without worry.
Helpful - 0
Avatar universal

I had Oral Test at 74 Days 10.5 weeks past Oral exposure, I guess I will try to put it to rest but another test may finally put my worries to rest since 12 weeks is the Gold Standard.  The internet claims as high as 6 month windows but really?
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
Did you have an Oraquick blood or oral fluids test?  The oral fluids test takes a bit longer than blood tests (either lab-based or rapid) to reach 100% reliability.

So no matter which test you had, the result is 100% reliable 115 days after the possible vaginal exposure. As already discussed, your oral exposure carried no risk and didn't require testing at all -- so I do not recommend further testing.  However, if you had the oral fluids version, 70 days is technically too early and you could consider another test at 3 months or more after the event. If I were in your situation personally, I wouldn't do it.  Up to you.
Helpful - 0
Avatar universal
Stats 74 Days Oral
          119 Days Vag ?

NEGATIVE
Oraquick 20-40 min reading

Is test conclusive enough even though they recommend 3 months, to move on. Or spend another $40 in 2 weeks

Thanks for your help  

Helpful - 0
Avatar universal
If the person was in Prague with a fragmentary memory caused by drunken blackout or maybe drugged then as you know higher risk sex activities could occur without recollection. I will follow up and am still scared but your answer has given me some assurance for the evening thanks Doc
Helpful - 0

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